Don't overcomplicate your recovery from pain and injury

What's the solution here? Take less swings like next time. I don't know. Do you think it's maybe like, you know, like maybe my back muscles are tied or maybe my hips need to be more mobile? No, man, just do less for a little bit. Do a little less. Let's make this simple here. Okay. You don't have to go full bore all the time. And family guy, I think had it right, but in a different way, Joe, the cop would be extreme. Let's not be extreme. I don't know what it's like in different countries, but I feel like in the U S there's like extreme, look at me, you know, how much can I lift? How much can I run? It's like, that's, that's like, that's like the thing that people idle.

You're listening to the restoring human movement podcast where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. And now your host, Dr. Sebastian Gonzales. Hey everyone. I'm Sebastian, your host with the restoring human movement podcast. Thanks for joining the movement movement. This is your first time. Welcome. It's a baby about, uh, it's about a 45 minute to an hour long format where you're either with me or me and someone I'm interviewing, uh, about how to really improve our patient outcome as clinicians. We want our patients to get better. Uh, but also we want our patients to understand what's being asked of them. And for that reason, I've created a couple of different styles of formats for this podcast. There's really a little bit more clinical stuff. And there's also things like, uh, what we're going to do today, which is patient friendly. And so the patient friendly ones, um, obviously the conversation can be very easy. Also in a lot of the conversational ones for clinical skills, there's also going to be very easy conversation. Cause as you're going to see in this podcast, I believe in making things as simple as possible. There's no reason to overcomplicate things if we don't need to. And so, um, yeah, it's friendly to most people who actually care.

I'll guess I'll put it that way. If you do not care about your body, you don't care about this podcast. Go find a Joe Rogan. Maybe there's something else on there. So please subscribe to this podcast. This is the only way you're going to get access to all of them as they release. If you're listening to the single podcast right now and you like what you hear in the first 15 minutes, I said, I suggest you subscribe. Uh, we have over, over 200 episodes here and, um, there was a point middle of the year here where we slowed things down a little bit and did two or sorry, one podcast every two weeks, one release every two weeks, mainly so that you guys can catch up and listen to a lot of stuff back in the archives because the archive stuff is really legit. I'm not saying I'm running out of information, but, uh, you really need to go backwards because I personally have gotten more information about how to become a better clinician, how to become a better person, how to become a better, um, patient myself by interviewing people on this podcast and, and also, um, being able to relay my thoughts, hopefully in a simple way. So the format today, again, we're going to go into that. This is a solo podcast today. We're going to cover the topic of don't overcomplicate your recovery, I guess, and your life too. Before we do so, I'll get into a really short story about myself. So you understand who I am as a host and hopefully you like me enough to follow me through this journey that is improving, uh, my clinical experience. So we'll go into that short story and we'll get right on to the show today. So back in the day, I did a lot more soft tissue work with people as you might know, if you listen to the podcast, and I guess this is not necessarily a funny story today. This is just kind of where my brain's going and thinking with things is that I've, I've, I spend easily, easily 90% of the time, uh, in my office, more in the gym area, coaching people through, uh, exercise, corrective exercise, loading strategies, um, and empowering them. And, uh, I think I need to get better at queuing and coaching. And so I've been reading Nick Winkleman's book. If you guys have not read that yet, um, it's a good, it's a good, it's a good book, um, goes over something called silent sets. And so one thing that I'm going to start doing is noticing retention are people retaining the suggestions I'm making with their exercise and movement rather than just over coaching. So, um, just sharing that it's something that I need to improve on. I know we all need to improve on things, but that's the one thing I need to work on, uh, moving forward here. Now we're going to get into the show.

Okay. So I want this overall theme to be not over complicating things. All right. And this, this theory, or I guess, um, um, methodology covers a lot of parts of my life. I don't believe that we should overcomplicate a lot of things. Uh, and I think that we as humans tend to do that because we're always searching for a better way, you know, a optimized way. And I think what gets lost in the mix here is that, um, the simple wins. And a lot of people have a lot of success in life being, I want to say mediocre, you know, being good enough. We don't need to be good at everything. We need to be good enough and we need to be well-rounded too. Like I don't need to be stellar at making cakes, but maybe I need to make cake one day or at least confident in the, the strategies of making a cake. And knowing that I have to turn the oven on and I follow a recipe, I have to, you know, have all the ingredients and all might need stuff like baking soda and things like that. So just being prepared. Um, but I don't need to be a stellar chef. And so I guess that wouldn't be a, that'd be a baker. Sorry. So I think we tend to overcomplicate things in the medical world. Uh, not because we mean to, but it's because, uh, again, we have, we strive to know the exact diagnosis. We strive to, um, make sure we're pinpointing our care exactly to that problem.

But I think what we've done over the years is we've gone a little bit too far. The pendulum has swung quite a bit far into being so focal that it stalls care. It stalls recovery. And also too, I think we all know the body's one big unit, right? You, you can't, you can't necessarily have, I can't dump oil in one part of the ocean and expect it not to eventually get to the other side. And so treating things on a micro level, making suggestions on a micro level sometimes is needed, but I think we overdo it now is all. And by the way, I'm going to, I'm going to out myself early on in this podcast because I'm pretty sure I'm going to say some things that are kind of out of turn or like, um, but I'm, I just want to have some thought provoking things today. So I'm going to go much more off the cuff today. Um, I usually go off the cuff anyways, but I just want to, um, let you know ahead of time that I'm going to say things that I probably don't even believe in either. Um, but, but I'm just spitballing things and hopefully you guys, um, have some thought, uh, thought provoking moments with this is all I'm hoping for. So I don't think we can overcomplicate that. I don't think we should overcomplicate things. Um, but I think we do way too often. And I've been bad at that too. And I tend to think as a chiropractor or as a movement specialist that the body can bounce back, it can recover. All right. It can recover.

And I think a lot of you probably believe the same thing. If you've been listening to the show this long, you believe that the body is pretty resilient. If you can recover from sunburns, it can recover from cuts. It can recover from disc injuries. It can cover from ankle turns. Like the body will be resilient and the person will get better. And so kind of thinking of that too, like, I know this is going to be off the wall, but why do we even cast people with like very small, tiny fractures? Why do we even cast people? You know, back in the day, like when we had people, um, you know, let's say neonatal man, they had a fracture, a small, like say a small fracture, like they ran too much. They had a metatarsal stress fracture.

They would probably just not run for a little bit. And because, because it was painful, they would rest it. They would hobble. They would limp. The body would recover itself. So again, this might be overkill with going devil's advocate way, but why are we doing air casts and stuff on these things? Why are we telling, why are we giving crutches? Why are we doing wheelchairs? Why are we casting these people? Right. Why are we doing all that when we know the body can recover and it naturally should do so on its own? Like we didn't have cast and these plaster casts all the time. You know, maybe you put some sticks together and like, you know, put some, um, rope around them to, to keep them, uh, keep those compound ones in place, but the simple ones, why do we even bother?

And I think what happens, I know that at least this is what, what I've read when we cast too much, we immobilize too much too early is that we compromise bone density, which sets them out, uh, sets them up for failure later. It sets them up for a repeated fracture possibly. It also, um, deloads the tendons, deloads the muscles, deloads the ligaments. So are we really making this person better? You know, we're, we're robbing Peter to pay Paul in this type of scenario, but the fact remains that this person might, might still go out and run if we don't cast them. And I, and I heard a very good, um, explanation this before. And I said, when would you cast someone? When would you not?

And they said, when I don't trust the person. And so what if you, I'm like, what if you trust the person? Like, well, I give them a boot. They can take off. You know, I'm like, but you cast them when, when I don't trust it, they'll listen to me. And so I think people have this, most people I do every, I guess everybody does. They have this internal drive to do whatever they're doing, right? Somebody might run continually run, even though they've been advised not to, because they want to get a certain race time. They want to impress their girlfriend, their boyfriend. They want to, uh, they feel like if they don't run, that they get stressed out more at work. There's another deriving factor behind this. But if we put it, if we go down, like kind of boil things down simply, if things hurt, just don't run for a little bit. What happens if you just don't run?

Well, you probably feel better. You probably walk a little bit. It probably doesn't hurt to walk. Um, and it ends up feeling better. And when you feel better, you start to run again. Like this is probably what animals do, right? Like they did, their bellies don't feel good. They lay in a shade, the shade somewhere. They kind of like mope around for a couple of days and they go out and get, they get hungry, they get food. So do we need to over manage these cases? I don't know if we quite do. And I think as, as healthcare providers, we should more be guides about this kind of thing. and figure out, I guess, number one, should we, can we trust this person to do what we're asking them to do for their best interest? Or at least we give them the benefit of the doubt. If they fail, it's because they failed because they didn't listen or they had another thing that was more important to them than actually recovering from that foot. So I think we just mainly guide them. Now, do we actually do things treatment wise locally to the spot? Yeah, we can tinker around down there, but again, does it have to be complicated? Do we have to get really nitty gritty into the joints and mobilize this and stretch that and tape that? And do we really have to do that? I, again, I don't really know if we do, but, um, I guess I'll, I'll switch gears into a different, different idea is that I think people, if we just have them do the opposite of what they usually do, they got into this situation, I think we're going to find some magic there. Okay. So a lot of people, I guess we'll go have a couple of camps with this. And I already mentioned the first camp. The first camp is the doers and the doers like to do, you know, they have some type of drive. They have some other type of reason of why they're doing things they're doing. Um, they might not have a dimmer switch. They might not be able to, like, if you give them an inch, they'll take a mile. Hey, I want you to go out and hit some baseballs today. You hit 300 baseballs. I just said, take a couple of swings. They said, Oh, that felt so good. I just kept going. Well, how do you feel now? My back hurts now. Well, Oh, why do you think? I don't know. I think I'm just, you know, I'm getting old and no, dude, you took 300 swings and you haven't swung in four months. I'm pretty sure it's a spike in volume.

Okay. Um, and other people, again, they might not be doers. They're chill backers. They're the resters. Right. And so they're the people that, that got into the situation by not doing much, which is still doing something. It's just doing the opposite. And so some people get hurt by doing too much, uh, of one activity or doing too much activity where they just basically can't recover from it. Other people get hurt or I don't want to say hurt. Cause I guess that's a, it's a relative term here. Um, I don't know, by the way, I don't know, uh, it's a side topic. You guys are asked anyone, Hey, so what's your injury? They're like, well, I'm not injured.

Why are you here? Well, my, my hip hurts. So there's a, there's some, there's some terminology around that, which is a little bit sticky, but for the most part, people are in pain. Um, when they don't do anything either, when they sit too much, when they lay around too much, you know, so these 10 things tend to hurt too. And it confuses these people. Cause they're like, I'm not doing anything that would hurt me. Why am I hurting? Well, you're probably hurting cause you're doing too much of that activity. I know it seems like you're not doing anything, but you're still doing something. Uh, sometimes people get hurt by having too many stairs in their house. Other people get hurt by doing too many, um, too many miles on their Fitbit. Um, other people stress out too much. Other people look at the sun too much and their eyes hurt.

You know, other people stand out in the sun way too long and they end up burning their skin. And so there's a lot of different ways they can do too much, but I'm going to make this super easy for everybody. Do the opposite for a little bit. Well, what do I mean by that? Well, if you swung, if you played, let's just go back to the baseball analogy, cause this did happen. Uh, we had a guy who, um, we were playing baseball and, um, everybody was really excited to really go out and finally get some, some swings and throws in. So it was like a four hour practice, you know, um, sprinting, running, hitting, throwing. And, uh, you know, a couple of excited guys like, yeah, there's a couple guys like, yeah, my, my back really hurts. Well, how come I just, you know, I didn't do my warmup and, you know, I was excited to, okay. So, um, maybe we don't have that spike in volume. Maybe like I actually had a good friend. He, he came and, um, he didn't know he hadn't played in many years and, um, the, he had not swung a baseball bat in probably 30 years. And so he also didn't know the etiquette of like batting practice. So he was the first, there was like 15, 20 of us there. And so he was the first one, he literally took 80 swings. He did the entire bucket. And, uh, afterwards I was like, number one, I'm like, do you know, hitting etiquette? Like you just kind of like 20, 20, you ever wonder why the batting cages are like 13 pitches. It's kind of like you're supposed to switch, you know, obviously when you're at bat in a, um, live arm type of situation, maybe 20, 25 swings is pretty good. And then a good one, you know, that that's it. You don't eat the whole bucket. He's like, Oh, I didn't know. I'm like, yeah, that's cool. You know, like, but you actually started something. Now, now the next person also took, uh, 80 swings too.

And so this took forever. So that's etiquette. Number one, second thing is, uh, Lee, he came over a little later that night. Um, he was sitting down for a little bit. We're talking, he got up, he doubled down and went to the floor. Like he could not, um, get off hands off the knees, like a, like a shortstop position. He had to go prop himself up on a wall. Um, his back was just lit up. His abs were lit up. His oblique areas were lit up. Um, it took him a couple of days to really get out of this. He's like, Oh man, what happened? I was like, dude, you took 80 swings. You haven't swung that hard. You haven't moved and rotated that hard in 30 years. All you do is lift weights.

You go sagittal, man. You go forward backwards. You barely go side to side, you know? So how can you really expect your body to tolerate that? So what's the solution here? Take less swings like next time. I don't know. Do you think it's maybe like, you know, like maybe my back muscles are tied or maybe my hips need to be more mobile. No, man, just do less for a little bit, do a little less. Let's make this simple here. Okay. You don't have to go full bore all the time. And, and family guy, I think had it right, but in the different way, Joe, the cop would be extreme. Let's not be extreme. I don't know what it's like in different countries, but I feel like in the U S there's like extreme. Look at me, you know, how much can I lift? How much can I run? It's like, that's, that's like, that's like the thing that people idle, you know, why aren't five K's so pop? Like why aren't five K's more popular than a marathon, half marathon, Ironman, you know, um, double orange, things like that.

Why are they not more popular? Five K's are so freaking hard. You can go into, you literally puke, I don't see hardly anybody puke on like a hundred, like a century run, you know, like a century rides. Um, I don't see a hundred mile clubs with running. I don't see people typically puke. They just kind of go slow and steady, right? Not that that's not hard in their own right, but they're all, they're equally hard in different ways. And so I feel like more is always idolized. I don't think that should be. So let's go back into that. Um, how we might make things simple, um, in those scenarios. And so, um, let's just say, say with that baseball analogy again. And so we have people playing for like four hours. I was no exception. Um, I was out there playing. I was happy to be out there. Um, and my ham, my right hamstring got kind of tight, probably ridiculous.

I'm not going to lie. Um, cause it went a little bit into the calf too. Now, was it because, um, I spent four hours sprinting around when I had not been sprinting for a while, maybe, you know, and so maybe a remedy with that is dude, why don't you just take a break every hour, go sit down the shade, have a drink, relax, talk to the guys. You know, I know that one of the things I really enjoyed with going to baseball, um, the last couple of weeks was that, uh, I like seeing people, you know, I think when you go into like, um, you know, those scenarios where you're wondering, Oh, how do people have really long lives? How are they really like, like what's different about these people? Um, and, and I think you, you might notice that some people like they're the quote unquote anomalies, right? They've drank for years, they eat poorly and they live for a long time, but they're happy and jolly people. Like they, they don't worry about stuff. Um, uh, I, I, I, I don't want to pinpoint out any single country, but I, what reminds me of, um, of this is my Italian friends, you know, manja, manja, eat more food, like drink wine. Like it's like 11 o'clock.

Yeah. I have some wine. It's all good. Right. And they're all happy. Like it's community, you know? Um, I don't know the longevity over there, but I kind of almost wonder like, is it healthier to be just around, you know, people and, and have a good time versus stress out. And, you know, how many swings can I get in? How much can I impress people on Instagram with the miles that I ran in the pace and so on? Why can't we just make this whole thing simpler and just don't do any of that stuff. Don't do so much of it. Okay. Dan, John has some really good, uh, sayings with, uh, I think it's Dan John anyways, but you know, do just enough, you know, challenge yourself every once in a while, but not all the time, you know? Um, so there's, there's magic in the middle.

And I think that comes with a lot of different things. Um, the magic's in the middle with, I think running magic, obviously you're not going to be stellar and we're not talking about, I guess I should exclude groups. Yes. If you want to be professional athlete and Olympian, by all means, you're an exception to this rule, but most of us aren't. I'm pretty sure everybody listening to this podcast is not a professional athlete. And I think we need to all look ourselves in the mirror and say that because once you realize that nobody gives a shit about your times and your performance, except for you, it makes it okay to not be stellar. Just have a good time.

You know, I think, I think if we were to sit less, I think if we were to walk more or if you walk too much, walk less, sit more, read a book more. Um, if you don't go out in the sun, go out in the sun, you know, all this stuff, just meet in the middle somewhere. Case presentation wise, I can give you a couple examples of cases that we've had over the last, um, year or so, which are, um, maybe how we can plug this, this type of thing in. I know I've probably been all over the place with this podcast today, but I'm just going off the cuff. Cause I feel like maybe I personally feel like I've had more bombardment of, um, what's, what's my right diagnosis, dude. It's one of these two, but do something. I don't know. I can't do anything until I know the exact, okay. If you want to, you can go burn, you know, like six, $700 on an MRI, plus you got to get x-rays first, probably.

And we'll see if anything's there. Oh, you got your MRI. Okay. So, uh, what's wrong with it then? I don't know. Everything's normal. Okay. So we've already burnt like a month now. Uh, are you ready to do something now? I don't know. I need to figure out exactly what it is, dude. I'm telling you just walk, just go for a walk. How's it feel walking? It feels really good walking. Just walk. What do you mean? Just walk, walk more. Why? Cause it makes you feel good. Do what makes you feel good. But what's wrong with me? Nothing's wrong with you. Okay. Your body is just a little angry at something. Just do what feels good. The, your, your pain is telling you what is good for it and what's not do what feels good. I don't know. I need to think, I think I need to figure out what's wrong. This type of mentality is, is super common. And I don't know if you guys find it too, or I don't know if you as, as patients or lay public feel this way. It's natural to feel this way. I've felt this way too. I totally get it. But I think what you're going to find is if you just do something like Alice Snow says, do something, forgetting Sarah Marshall. Um, if you just do something, you're going to be surprised that you'll feel better and that it, and that you won't care about what it was. People only care about what their quote unquote diagnosis is. If they're having, if they don't feel better or if there's something currently wrong. Now, obviously it's very important in some situations to have the correct diagnosis because the treatment needs to be pinpoint and focal.

But I think for musculoskeletal, for a lot of musculoskeletal, it doesn't really matter as much as we think. I know I might be the devil in this. Okay. Uh, uh, which, which type of instability we're looking at? I don't know. Just stabilize it. Is it, is it a surgical case? No. Okay. Then just treat it like a shoulder, stabilize it, make it happy. So I think we just need to do something. And what should we do? This is the part gets a little tricky. Okay. The thing is, if this is a mechanical problem, sometimes doing something, doing the thing that's wrong will make you feel worse. But let's just use a really quick analogy with a bed. Okay. Hey doc, what kind of bed should I get? Well, I don't, what kind of bed do you have? I have a, uh, it's kind of in the middle, you know, it's not firm. It's not hard. Uh, I have a pillow topper, you know, great, cool. Um, so you're, you're dead set on getting a new bed. Okay. Why don't we do this? Why don't you just lay in the ground for a night? Well, why would I do that? Well, um, you want to test what a hard surface is like, right? Let's just see how you sleep for a couple of nights on, on the ground. Just put your pillow topper on the ground. You got a firm bottom to it. You got the ground and just sleep on that and see how you feel. I don't know. Like, I think I should try soft it. Okay, fine. Try soft. The point is do something. Now doc, what if I wake up and I feel worse? Then we know that try that for a couple of nights. Then we know if it continually makes you feel worse, then don't get a hard mattress, get a soft one. The thing is we're collecting information. You're collecting information. Being, not doing anything doesn't get you anywhere.

At least if you're going the wrong direction, your body knows, your body's going to tell you that it's not right. Well, how will I know? It'll hurt. It'll probably hurt. Well, I don't know if I can feel comfortable, uh, dissecting that. Good. You don't have to come in and talk to me about it. This is why we're here. We're here to guide you, but you need to do something. We can't do it for you. So, um, maybe, uh, now we go down, maybe a corrective exercise, a treatment route with this. Like, so, um, yeah, your, your hip hurts. Um, why don't we do, uh, bridges? Well, I, is that the, are you sure that's the right exercise for me? I'm a little concerned. Uh, why are you concerned?

Cause it might make you worse. Well, why don't we try a couple? Uh, why don't we do 10 of them? Did that make you worse? No, it didn't. Let's do 20. That make you worse. No, it didn't. Let's do 40. That make you worse. No, it didn't. Let's do a hundred. You see where I'm going with this. Did that make you worse? No, it didn't. Okay. We did a hundred reps of this. It's probably not going to make you worse. If I bent your finger backwards, 10 times, a hundred times really aggressively with a lot of range, it probably, if that wasn't good for the journey, it would probably say something around number 20. You got through a hundred and it made you feel better. You walked around. You felt better, right? Your hip felt better. Good. So I think that's a good route to take right now. Are you doing bridges right now? No, I'm not. I'm not doing anything. Good.

Do something. Well, what if it doesn't help? Then come back and talk to me about it. Well, then what are we going to do then? Probably not the bridges. You see where I'm going with this? We'll do the opposite. Um, shoulder cases, neck cases, they're kind of similar. It's, uh, you know, um, well, I stretch it this way. Does that help? Uh, it doesn't help. Okay. You figured out the wrong thing. Let's do the opposite. Well, which way should I do? I don't know anything but that. So a lot of people will create these positive feedback loops with their, with their, uh, activity because they're picking the wrong one, but they're not, but they're kind of married to the idea. And so don't get married to the idea. Just look at yourself as a little science experiment, have someone help you dissect the information down such as people like us, um, or clinicians that you feel that is going to take the time of day and listen to you, uh, and then go from there. But at least you're not in the no man's land.

You got to do something. So I'll give you a couple examples of cases that we just kind of did stuff and just saw what was happening. And they're not always things that you would think, um, are, uh, there, I try to pick things that are not like nuance. They're not things that are extremely focal unless they need to be focal, but they'll address many different things at one time. Now, really quick break from the show. I want to propose a educational series to you guys, for you clinicians out there. This is not intended for patients. Uh, I recorded a webinar series, um, a little while back I recorded it. It's over 15 hours easily when you put all six parts together, but I broke them up into two, three hour bits. We cover what I call the five-step patient care system. And I've developed this because I've been training interns and this is a good way to organize thoughts for them. And also easy way for me to teach too. And so step one is history taking working diagnosis, physical examination, dynamic testing, and good example. It's just really good, solid example of knowing when to use them for hips and shoulders and backs and cervical and so on.

Also, we do cover first days, how to get people out of pain without having to use medications and really without even having to put our hands too much on them either. That's very empowering shit for people to be able to do stuff on their own. We also cover corrective exercises, which is number three and when to use them, how to use them, which ones to use, how to cue, how to cue them, how to coach them. Then we cover loading. DMACC, Dr. DMACC also covers a little bit into the other products we have on the page too. That one is, if you want to go a little bit more into depth on number four, which is loading, Dr. DMACC covers that again in 12 hours of the low back one, or sorry, no, it's two hours. Two hours of the low back one and another two hours of upper quarter and cervical spine. As you can see, I cannot fit it completely within the five-step series because it takes more detail than that. He covers it a little bit more thoroughly in there, but I do make introductions into it and I do do some of my coaching and cueing style too, which is a little bit different than his. However, I want you guys to go through this and really take the heart of the, what I'm going to say is, and taking the light that is intended. If you don't get this, shame on you. Shame on you because it is one of the most educational, useful, cheapest series that you can possibly get to improve your clinical knowledge. Again, I don't say that lightly, but I feel like a dick when I say it is if you don't get it, I don't know what you're spending your money on. I don't know why you're going to all these other workshops that show only little tiny parts of things. And so this is an organizational series. I know a lot of you already know how to do tissue work. You already know how to do some stretching techniques. You already know some exercise techniques. Why do more? Why do more?

You might as well just figure out where you're missing things and learn that one. Learn how to plug in those things you already know. Many of you are very, very good at tissue work already and you don't need to go to more. I know that I spend a lot of time doing a lot of tissue work. I don't need to learn a lot more. I probably need a little bit more, but not a lot more. I need to figure out where my competencies are lacking. And for many years, my competency was lacking in corrective exercise, QN, and loading strategies. And so after plugging those things in, man, freaking game changer, freaking game changer. Anyways, we cover hip, shoulder, low back, cervical spine, and referred symptoms. I'm going to share with you a review that we have on the low back one taken by one of the people who went through the course as I taught it live. I highly recommend this guide to any chiropractor and physical therapist looking to up their game in treatment of the low back.

The guide is a great supplement to anyone who likes crisp book protocols by Don Murphy. If you read those books and agree with the patient's needs to have better control of their own health, then you will love this. Sebastian Gonzales gives you a step-by-step guideline of what to look for in examples of exercises for treatments that will be useful the next day, not just theories and concepts. Great. Well written. I like that. So please go through there. Again, take my comments in the light that it was intended. I want everyone to improve. I want our profession to improve. I continue to learn people who have been around longer than me as well. Um, and there's no need for everyone to struggle and try to reinvent the wheel. I know our, we get frustrated when our patients try to struggle through some of the easy stuff that you could teach them. Um, don't make the same mistake they do. Don't let them go around on YouTube videos, looking for solutions when you have an easy solution for them. So P2 sports care.com slash products. You won't be disappointed. We'll see on the other side. Back to the show. So the first case we're going to go into was one that, uh, I didn't work on. I just kind of brainstormed, uh, with Dawne Costantino with it is that we, we talked about someone with hand numbness. They had a hand numbness when they were seated mainly up throughout the day. They were actually pretty good. Um, but they weren't really doing a lot of activity from what I recall about the discussion. Um, there were things that made their pain go away.

Um, and it really helped out. I take that back. They did have some pain throughout the day. So it became just mainly circumstantial, like at, at, at the computer, at the desk. And so it would go numb in the fingers very, very quickly within minutes at the desk. And so we did a bunch of nuanced things. We did stuff for the neck cause it was, it was in the neck. Um, or she did rather, uh, she did stuff for the shoulder blades. She did some Brugers. She did some pec stretching, you know, things like that, like stuff up in that area, um, to address the possibility that it's the upper back rounding, chin poking, seated posture, normal stuff that goes out into the fingertips and so on.

And so, um, it became stagnant for a little bit. And so what was occurring was that daily life, again, it was not triggering. There was nothing going on. It was normal. So it was very, uh, the person was very happy. Um, but it would come back when being seated. And so we talked about it a little bit and we took some of the Dan John principles about just figure out what's lacking, do it kind of again, in the example of if your skin's not tan, go outside, you know? And so you kind of already worked on pushing, pulling carries, like things of the upper body. It's already kind of being done. Obviously we know the body's body's one unit. We can't really isolate these things, um, down into one area, but it's kind of more biased. And we all kind of know that pressing will get the shoulder blades, the pecs, the serratus, they'll get all that stuff, right? It doesn't really get the legs unless you're doing a standing push. Um, but it kind of eliminates a little bit more of the lower half, especially when we're in the corrective exercise world. And so we just kind of brainstormed. It's like, have you squatted and hinged him yet?

You know? And we're like, no, that's kind of lacking. And why don't we just do that and see what happens? You know, like worst case scenario, he gets a little leg workout and then that's it. Um, the theory being that maybe the upper body is supported by the lower body. Huh? Think about that one. Right. And so, uh, after doing just one session of that, doing the opposite, doing the other stuff, not getting so nuanced, he was able to sit for hours with no numbness in the fingers, nothing else changed. Imagine that. Okay. And so again, that's an idea of just do something else. If things aren't working, do something else. Another case that we had, uh, was somebody who had an accessory bone in the foot or in the ankle rather. And so, uh, he was pretty convinced he's going to have to have a surgery for it. And so, um, he, um, he'd been told he'd had this for years.

Obviously accessory bones are kind of just there. They're, you know, it's like a tail. You just have an extra one. And so they don't always create pain with people, but you know, he, um, he was obviously having some, uh, issues with it. So he wanted to get it addressed sooner than later. Um, not a very old guy, either, um, under 30. And so we, uh, we were actually seeing him for something else. We were seeing him for, uh, something into the hip area. And so, um, some of the suggestions that I made for the hip, they could have made a good change on the ankle pain. Um, but as, as he was in for the hip, I, we mainly stuck with hip stuff, but to be able to kill off a lot of birds with one stone, um, I told him, look, we're going to use that. Uh, we used a, um, uh, a heel raise exercise, uh, just on a wall to figure out where, how the ankle was feeling after each intervention for the hip, just to see because again, the body's one big unit. And so, um, after each one time and time again, we did about three times, three things. Um, it helped that we ended up helping the hip. It didn't help the ankle.

And so kind of going off of what I saw with the hip, um, he was not putting weight onto the side of the ankle on that limb, make complete sense. Uh, it was also, that was the same side as the hip. So, um, he's also taking weight off that side of the hip. And so usually we'll say again, make it easy. He's like, huh, you know, I put weight on that leg. There's, there's, we've examined it. There's no, there's no orthopedic reason to not load that side. Let's just load the side and see what happens. And so, um, we took him into a single leg stance, um, uh, SLDL reach across the body, um, or a boulder or a, we call them Stanley touches because Stanley, the shark is the mascot. And we just kind of reach across our body and touch Stanley. Basically it's a single leg balance, reach long, quote unquote, standing bird dog type of thing, boulder. Um, and so this really gets into that left hip, but one side versus the other, we did both sides. Um, he really had a hard time balancing on that left leg on the left foot. He couldn't keep the foot pinned to the ground. He couldn't preserve his arches, couldn't dome the foot. So there was, there was a lot of things that were just kind of iffy there. And so we started cuing in a little bit more towards just, just keep your foot on the ground. You don't have to go too far. Just start reaching, challenge the foot. Just make, make sure that you're, make sure that you're, um, sticking to the ground. And so he paused at some point and he's like, yeah, I got to take a break. And it's like, how come? He's like, cause my, my, my arches are tired. I was like, ah, your arches are tired more so than your hip and thigh.

That's interesting. Okay. Keep going. And so we kept drilling him out with that. And then he did some, uh, heel raises after that. And all of a sudden he's like, Oh God, that's like halfway better on my, on my, um, on my ankle, his hip. Again, it was something we were doing for his hip already, but we can kill off a lot of birds who are once done with this. And, um, now could we have done short arch exercises and, you know, curling the towel and spreading the peanut butter? And then all, yeah, we could have. And in some situations that's needed, but in this situation, we had a big, long chain, a big, long limb right there that wasn't accepting any weight anyways. Why don't we just load the entire thing and just see what happens? Okay. He wasn't doing it already. I know he was more afraid to do it, but do what you're not doing. And so he was kind of taking weight off that side for an excessive amount of time. Granted after a couple of days, if you had a fracture or something, it would be a, or an active tendonitis. Yeah. Take some weight off it. No big deal. You turn your ankle. No big deal. Take some, take some weight off it. But if you're doing it for months and months and months, maybe we do the opposite and put some weight on that side, stand on that leg a little bit. I remember I had a guy that come in one time that he had side on the right leg. And, um, he he's like, yeah, I feel like it only feels good if I take weight off it. I said, can you just put some weight on your right leg? Just lean on your right, right leg. Cause you kind of standing there talking to me. I put weight on, put weight on your right leg. Let's see what happens. He's like, oh, yeah, it feels better. Okay. So put weight on your left leg. All right. I came back again, put weight on your right leg. So putting weight on the side that was the symptom side made him feel better. Again, doing the thing that he was not wanting to do. We also see people, uh, see people with this type of thing. If they, after they've had a disc injury in the low back, they tend to not want around their back. Um, and then when you eventually get them around their back, a lot of their back stiffness goes away. Again, the active or acute situation has to be resolved. Um, but pain would usually tell people that too. You'd be floored. You'd be floored if you, if you still had the active disc and you started around in your back in most cases, but the body heals itself up, do the opposite, do what you're not doing.

And you might be surprised at the results with things. So, uh, again, let's, let's just recap. I'll go back into one more case after this. If you feel like you're avoiding something and there's no really good reason to not avoid it anymore, you might consider adding it back in. Okay. Now, how can we be sure that it's safe to add it back in, have someone examine you, have someone stress test that joint, have someone make sure that, um, they checked under the hood, kick the tires of the car before you go drag race it. But avoidance of it will create other types of problems. And you might be surprised how many things just go away. Once you start adding the things in that you're not doing, are you stressed out? Go for a walk. Do you feel like you're low in vitamin D and you're inside all the time? Go outside a little bit, get some sun. Do you feel like you're depressed because you, um, um, you feel like you're, you're, you haven't seen your friends or whatever. Talk to your friends, see, you know, hang out in a park, talk to them on the phone. There's a lot of things that are in our control here. Um, and I think all we need to do is realize what would just ask yourself, what would make this better? What are possibilities that would make this better? What are ways that I can make my, um, um, let's, uh, vitamin D come back. Um, well, you can take a supplement. That's one option. You can go outside. That's another option. You can eat better food. Maybe it's another option. I don't know. I'm not a nutritionist or dietitian, but maybe those would be things, right now. Um, things that maybe might make you feel better, um, depression wise. Um, cause again, I'm not a psychologist, but some simple things for me, God, I really wish I was in the outdoors more. Okay. I just need to take a Friday off and go camping. I need to go backpack. I need to hike.

I need to sleep in a truck by myself and start a fire and just make some stakes over the fire. What else would make me feel better? Well, um, maybe not working so late. You know, I really like the idea of not having to come home at seven, seven 30, eat real quick, and then get ready for bed and feel like I'm still thinking about work. Maybe I'm done at five. That's something that's the, all these things are under my control. What if I want my back to feel better? Well, what do I think that I need? Um, or what are possibilities of things that I need? Well, I I've been avoiding lifting and I have not been running. Well, maybe I can set some time aside. I do do some lifting with patients. Um, but it's not really the lifting that's program that would program for me. And so I can do a couple of things there. I can, uh, ask them to do the lifts that I'm doing, which maybe is not what I want to do because they're paying for my time. Uh, but I can set time aside and just, uh, come in on a day off and spend 30 minutes and just do the work. I could ask a friend to keep me accountable to go running with him. I can walk more right when I get off work. That will hopefully, hopefully keep my mind off of, um, troubleshooting at work too. Um, walking, uh, looking around, seeing the sun, seeing the birds chirp. Um, it'll help unload the back a little bit. It'll help. Um, I'll, I'll talk with Allie, you know, we'll, we'll talk about things that are not work related. Um, and all that will help. So although we say that maybe these recommendations of like walking, going outside, they're very simple. They address a lot of things. They address a lot of things. Drinking water is an, uh, an example. I'd tell people to drink water multiple times a day. If they have neck pain, is it about the water? No, maybe not. I mean, drinking water will help out, you know, hydrate them, all that good stuff, make us other insides are moving well. Um, but they're looking up rather than looking down and they're going to have to pee. So they have to walk, they have to swing their arms.

Um, and so they have to, they have to move. And so these recommendations, the simple recommendations can really go a long ways. Now, before I close on this, uh, I'm going to give one more case example, which I thought was, uh, it's, it's just another example of just do the opposite. I had one guy come in that he, he was having shoulder pain. And so he really did like working out. Um, he liked to do, um, his workout that he's been doing for a long time. Um, and I said, well, what's that workout like, you know, and this is a, again, from clinical standpoint, just ask, ask details, be curious about what is going on with this person, what they like doing and what they have been doing.

And, um, so he's like, I like to really do presses. Okay. So I said, okay. So actually, sorry, I take it back. He said, I liked, I just do a standard workout. I said, okay, what does that look like? And he said, I do chest press and incline press and bench press and dumbbell flies and pec deck. And I said, okay. Um, so that's probably what you do the other days. He's like, I do it again. Five days a week. I do this. I said, do you ever put, do you ever squat? You ever deadlift? He's like, yeah, I deadlift. I don't really like squatting anymore. Okay. So you ever carry objects? No, I don't do that. You ever do pull-ups? You ever do rowing? Uh, I have not done that a lot. You know, I should be doing that, but okay, here's what we're going to do.

In this case, I didn't even really treat his shoulder that much. I did a little bit of tissue work. Um, did a little bit of mid back extension work with him and I helped out with his neck just to facilitate the process. But I added some positives, but I'm going to take away some negatives for him. Uh, and, and I said, look for one week, I'm going to take out nearly all of your pressing movements, except for a plank. I want to push up position plank with high tension. That's it. But we're going to add a bunch of, a bunch of pulling movements. And so I gave him three variations of pulling movements.

And I think I gave him like a door jam squat just to get the hips moving into the squatting patterning because he had not been using it. And so, um, he did that. He came back. He's like, wow, I'm like 80, 90% better. This is great. Now what? I said, let's add the pushing movements back again, but don't get rid of the pulling for a bit. And so we're just plugging in the holes here. Um, he's creating his imbalances with his, uh, activity, the holes in the activity. Um, and sometimes these things are hard to see for people. And this is why you should always pay someone for professional help. I pay some, I pay people for professional help. Um, I try not to do, I mean, I always, I do do some troubleshooting on my own, obviously like everybody does. And then when you hit a stagnant point, you ask for help and you pay that person for their help. And so, uh, in, in this case, he asked for help. We found the hole in the program. You plugged the hole.

It was good. All right. So that's again, an example of just do the opposite. Just do the opposite. And like I said, in the beginning, these things don't need to be overly complicated. You just need someone to reveal the holes in your program, in your life, in your activity. Um, and just get you to do the opposite. Walmart greeters stand too much, sit more people who sit at a desk, sit too much, stand up more. I know there's a lot of people trying to get standing desks nowadays. Uh, and they, uh, they're going to have other problems too. Um, and I guess we've probably all seen people do home programming now, like home workouts. Uh, they, they're an example of, uh, a spike too much of a spike because they have, when they transitioned from doing one thing to another, they did it too extremely extreme. So don't be too extreme. Just slow and steady wins the race.

Keep things sustainable. Drink lots of water, go on a walk, do things that feel healthy on your brain and your body. And don't stress out too much, man. Like don't, don't overthink things. Don't sweat the small things. Just relax. Um, things are not that extreme. I don't want to say extreme again. Um, things are not as, um, important as you think they are. All right. I feel like, um, I know that a lot of people have probably been out in the wild and I'll probably stop after this cause I'm going to start rambling. But I remember when, I remember when I went to Zion and I was about to go backpack.

And so the, the day before, or sorry, the morning of, um, I had, I had, that was the first morning there and I'd gotten there the prior day. I didn't know anything about what was going to happen in the morning. And so I was in the tent that night, just freezing my ass off. And they had told me, uh, no fires, which there was a fire ring, by the way, if you go to Zion, there's fire rings right there. Um, in, in watchman camp. And so I was freezing my ass off and I was in the tent and I took literally every piece of clothing that I had brought. Um, it was in February. Um, the wind was just whipping through. Like I didn't want to get out of the tent. I did like pinot big water bottle cause I did not want to get out of the tent. Um, and in the morning I wanted to make some bad-ass coffee. And so I, I started my whisper light up, did it right by the wheel wall of my car and just hid behind this tire trying to get warm, not worrying about anything else. All right.

Sometimes just going back to the basics, getting a little uncomfortable will make it so you start realizing what's important and stop stressing about those little bullshit. You know, all that stuff's not as important as you think. And you go back into the basics, you get into like, I just need heat, water, love, sex, all those things. Like those are like the basics. I think if we talk about Maslow's needs, you know, just go back to the basics. And I think you'll be more primally happy. That's just, again, my thought people might disagree with me. I'm no psychologist. Um, but that is, um, my thought-provoking things for the day. So, uh, thank you for listening to the podcast today. Again, a little bit different format today. I usually don't, um, lecture and ramble on this type of thing. Um, but I do think, uh, I, I think my, my, uh, my clinical guidance and thought process kind of falls along this line as well. So I, I think it was going to be helpful for everybody to understand that. Um, although we can go into the ringer about what's the exact diagnosis, you don't know exactly how to treat that thing. Just plug the holes, make it simple, do the opposite.

And these things have really made it easy for me to narrow down people's treatment plans, uh, and actually get a lot of bang for buck. A lot of things get better surprisingly without getting too nuanced with things, but I need, do need to make sure they don't need to be in the office. Um, as it says in the crisp manuals, uh, do they need to be in the office? Um, what's driving their symptoms or sorry, what's career, what's the symptom generator as such as the diagnosis or what's driving their condition to continue. So sometimes their activities, hobbies, um, and spikes are what's driving their condition to continue. So even if you get that diagnosis, right, sometimes just doing the simple things, doing the opposite, we'll, we'll get rid of that driver and it should self-resolve.

The body is pretty resilient. It will self-resolve in most situations, but when it's not, we need to look at what's driving, it's driving the darn thing. Okay. Subscribe to the channel. Thanks for being part of the movement and I will see you guys next time.